Drawing from substantial evidence demonstrating cognitive biases in depression at various stages of information processing (i.e., attention, interpretation, memory, cognitive control), we argue for an approach that considers the interplay among these processes. This paper attempts to apply the combined cognitive bias hypothesis (Hirsch, Mathews, & Clark, 2006) to depression research and reviews competing theoretical frameworks that have guided research in this area. We draw on current findings from behavioral studies on the interplay between depression-related processing biases. These data indicate that various cognitive biases are associated. However, it is not clear whether single or multiple biases are most predictive of depressive symptoms. We conclude this article with theoretical and clinical implications of the current state of research in this field and propose a number of ways in which research on the combined cognitive bias hypothesis can be advanced. A State-of-the-art Major depression is a prevalent psychiatric disorder that is associated with debilitating symptomatic suffering, functional impairments, and high societal costs (Kessler & Wang, 2009). Notwithstanding a range of well-established psychological and pharmacological interventions, relapse and recurrence rates of depression remain high (Vittengl, Clark, Dunn, & Jarrett, 2007) indicating that current therapies do not sufficiently address vulnerability factors for this burdensome disorder. Moreover, with each successive depressive episode the risk for recurrence increases (Boland & Keller, 2009), which points to an expanding vulnerability with multiple episodes. Hence, profound insight into the mechanisms involved in the etiology and maintenance of major depression seems essential in improving contemporary treatment options and the prevention of depression.In the past three decades, research inspired by cognitive accounts of depression has been successful in identifying vulnerability factors for this disorder. Apart from substantial research examining depressive cognitive content as a vulnerability factor (e.g., negative thoughts), a promising line of research highlights the role of cognitive biases in the development, maintenance, and relapse/recurrence of depression (for reviews see Mathews & MacLeod, 2005). Research efforts in this particular area of interest have typically focused on abnormalities in attention, interpretation, and memory processes, which are considered to be instrumental in the understanding of the processes involved in these cognitive biases. More recently, there is growing interest into cognitive and neural mechanisms underlying cognitive control impairments, which may operate across a variety of cognitive biases. Indeed a substantial number of studies on emotional information processing in depressed samples provide evidence that depression is characterized by attention, interpretation, and memory biases, especially for negative information (see below).
COMBINED COGNITIVE BIAS HYPOTHESIS IN DEPRESSION 4This resea...